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Saturday, January 18, 2014

Being, Having, and Doing: The Metaphysics of Disease

This is a copy of an article I wrote forHighbrow Paleoin 2011. I have not edited it.

Several years ago, I had an acquaintance who had previously been diagnosed with diabetes. He began a low carb diet, against the advice of his doctor, (this was in the dark 90′s), and over a period of time his symptoms abated, until one day his doctor announced that he no longer had diabetes (though in a bizarre, but perhaps common feat of cognitive dissonance, she could not help but advise him that he “really should eat more carbs”). Of course, my friend hadn’t actually stopped being a diabetic. If he were to have started eating carbs again, as recommended, he would quickly have returned to his diabetic state. What it means to “be” a diabetic is to have the susceptibility to manifest diabetes under the right, or perhaps I should say wrong, circumstances.

We all have weaknesses, to a greater or lesser extent. We all have our own special ways in which our bodies break down in response to a poor environment. For some diseases, we call this “being”. We “are” diabetic, epileptic, alcoholic, schizophrenic. For some reason, we identify less with other diseases. A person merely “has” cancer, heart disease, Alzheimer’s, or MS, even though these are not considered less permanent conditions once identified, even if they can go into remission. It does seem somewhat arbitrary that a person who was theretofore “normal” suddenly becomes or acquires a disease that they then are or have for the rest of their lives regardless of whether the disease continues to manifest. There may be a sense in which we are all diabetic, for example, even never having had symptoms. We all have the potential to some degree, no matter how small, and just because the degree is not yet known, it doesn’t make it not so.

In any case, what truly matters to a person who is or has or happens to know they have a genetic predisposition to such a condition, is whether or not their body is doing that which characterizes the disease. It is for this reason that one would seek to optimize their environment: to prevent themselves from “doing” a disease state. The Paleo diet and lifestyle is conceived with this in mind. It is reasoned both from an evolutionary standpoint: eat only that kind of food to which the body is well-adapted; and from a clinical perspective: do not eat foods which tend to cause disease. Without seeking to re-enact the environment in which we evolved — an impossible, and not particularly desirable goal (civilization does have some benefits) — one attempts to create a metabolic environment which is maximally healthful, and to which we do not tend to respond by breaking down in our various ways.

For my part, I am a fat person living in a reasonably fit body. (Fat is one of those rare states that we treat linguistically as transient, even though the obese, pre-obese, and post-obese have a signature metabolic profile such that a formerly fat person is not the same as a naturally thin one. This contributes to the blaming of fat people for their condition that would never be tolerated for other diseases.) I haveBipolar II, but for some years now my moods have no longer been disordered, and I use no medication. I wasn’t able to achieve this with a diet that is “just” Paleo, however, or even just low in carbohydrate. My body continues to do fat and bipolar unless I eat nothing but meat (though coffee and tea are mercifully tolerated). No doubt, there are people for whom even this is not enough, and others for whom it is not necessary. My idiosyncratic susceptibilities are simply deeper than most. However, I consider it likely that a great many people will do without disease simply by following a Paleo or low carb diet, or both. If nothing else, they are starting points that make sense for anyone wishing to give their body the best chance to manifest wholeness and well-being, whatever its underlying constitution may be.

"I consider it likely that a great many people will do without disease simply by following a Paleo or low carb diet, or both."

I think you are right. For the past few years I've been trying to figure out if LC will work for Crohn's. I cannot say for sure, but I will say this: For more than 10 years I've suffered from fistulae. Repeated experimentation has shown they would only be suppressed whilst taking 6mp/azathioprine. Without I was stuffed. However, I've had no recurrence for over 2 years following a drug-free, strict LC diet. I stumbled upon LC when I discovered that during relapses my symptoms would considerably improve eating Mcdonalds cheeseburgers instead of my usual Michael Pollan-esque fare. Not quite LC, but it was heading in the right direction. LC was just an extention of what I naturally gravitated towards when extremely ill.

I still have issues though - LC hasn't been a miracle. Although it is close to a miracle knowing how bad it once was. Of course my gastroenterologist thinks it's mere coincidence. I don't. Trial and error over the past few years has shown me that more vegetation = more trouble. And so I have been eating very little. But I was consuming the usual LC stuff such as nuts, very dark chocolate, butter, cream, and some berries. Probably about 50gm carbs all up daily. So now it is all meat (and still a little cream in the coffee). 5 days so far. First 2 nights I didn't sleep well, but since then excellent! Ketones are high, stomach is calm, head is clear (no slight headaches that I often have). So far so good.

Michael, thank you so much for these comments. I'm glad you are feeling well, and I hope you keep us updated.

I have seen some experimentation around low-sugar diets for IBS, and low-fiber diets for IBS—both of which seem to have some success—but I've never read about experiments with the combination. I'm very curious to know how much if any of the failure of the two alone would be solved by the combination. Many of the current low carb proponents emphasise plants and fiber. Perhaps they want to make it more acceptable to the mainstream, which is a value I share. It may, however, make it less effective for some issues.

" In AUG 2009, I started eating a meat-only diet. I crapped my brains out for three months until stabilizing in OCT 2009.

"In NOV 2009, I stopped taking my medication.

"In AUG 2010, I had a polyp removed from my intestine during my yearly colonoscopy and started drinking milk.

"In Jan 2011, I started eating small amounts of potato starch.

"In AUG 2011, I had a clean enough colonoscopy to warrant a two year gap until my next one.

"Between that time and AUG 2013, I ate potatoes, ice cream, fresh vegetables, drank gallons of Lactaid (all on top of a diet of mostly meat, of course) without obvious negative consequence. I avoided gluten strictly, and while I didn’t count calories or carbs, I suspect that aside from heavy milk times I was still lower-carb than the general population.

"In AUG 2013, I had another clean colonoscopy, warranting a three year gap until my next one."

Thanks Amber. I had seen that website a few years back. Very interesting. I didn't know there was a recent update. There must be a few people trying something similar. Unfortunately the standard recommendation for people with Crohn's appears to be: go easy on the meat & fat, it's hard to digest. LOL

I believe the opposite is true. And perhaps nuts were not so good for me. Maybe some nice prebiotics in there (in so far as that's important, which is questionable), but they also seem to cause bloating. I'm very interested to see how this meat diet pans out in the longer term in my case. But I'm very hopeful, and I certainly don't get bored eating meat and seafood.

I think the low-fiber and low-sugar diets in the case of IBS and IBD do indeed have some success. The FODMAP-limiting approach is very popular, but I think hugely confounded by the fact that it restricts quite many carbs in the process - so what is doing what? My gastroenterologist has been involved in many of the FODMAP studies, yet he doesn't see any use in what I'm doing. Ha.

Never mind. I think you're right about the emphasis on plants and fiber being necessary for mainstream acceptance. But I also think many are actually convinced this is the case. I just read Denise Minger's book. More of the same. For example, how berries and vegetation stored for winter were "nutritionally vital" for the Eskimo. Also a scare story about meat cooked at high heat, and one about thyroid problems on LC - all with appropriate caveats of course. (Very fine effort by Denise otherwise, though.)

At the moment I'm rereading "Not By Bread Alone", and I must say that the 1-year all-meat study still makes a powerful case. Also, it's very nice to read a book by someone who truly believes it's ok not to eat vegetation.

I just noticed that the person behind this crohnscarnivore blog comments on Paleohacks. Has some very reasonable comments there, e.g., http://paleohacks.com/questions/17591/what-are-some-pros-and-cons-of-a-muscle-meat-and-a.html#answer-17609I don't do Paleohacks, but you may have noticed his comments there before.